High pressure resuscitating and ventilating system incorporating humidifying means for the breathing mixture

ABSTRACT

A resuscitating and ventilating system is provided wherein a relatively high pressure breathing gas mixture is utilized. The flow of the breathing mixture is cyclically controlled by inflating and deflating valve means, which valve means is actuated by an air motor driven by the high pressure gas. A high pressure piping system connects the source of high pressure gas to the valve means and to the gas supply pipe of the motor. A gas-bubbling-through-water type humidifier is incorporated in the system. The gas inlet of the humidifier tank is connected to the high pressure piping system upstream of its connection to the gas supply pipe of the motor, and the outlet pipe of the humidifier tank is connected to the high pressure piping downstream of its connection to the gas supply pipe of the motor. Thus, the humidifying system bypasses the motor. Further, a water supply is connected to the humidifying tank and the connections are so controlled by valves whereby the water in the tank may be replenished without shutting off the flow of the breathing mixture to the patient.

United States Patent Jacobs mi 3,766,914 Oct. 23, 1973 HIGH PRESSURE RESUSCITATING AND VENTILATING SYSTEM INCORPORATING HUMIDIFYING MEANS FOR THE BREATHING MIXTURE Inventor: Harvey Barry Jacobs, Reston, Va.

Filed: July 15, 1971 Appl. No.: 162,944

Related US. Application Data Continuation-impart of Ser. No. 59,206, July 29, 1970, Pat. No. 3,682,166.

US. Cl. I28/I45.8, 128/194, 261/121 Int. Cl. A6lm 16/00 Field of Search 128/351, 145.8, 145.6,

I References Cited UNITED STATES PATENTS 8/1972 .Iacobs..- 128/145.8 H1957 Bunch 261/12] R 8/1966 Andreasen... 128/l45.5 4/1970 Hoel l28/l45.8

Primary Examiner-Richard A. Gaudet Assistant Examiner-G. F. Dunne Attorney-Abraham A. Saffitz SUCTION SOURCE OXYGEN OR AIR SOURCE WATER SUPPL DRAINAGE VALVE [57] ABSTRACT A resuscitating and ventilating system is provided wherein a relatively high pressure breathing gas mixture is utilized. The flow of the breathing mixture is cyclically controlled by inflating and deflating valve means, which valve means is actuated by an air motor driven by the high pressure gas. A high pressure piping system connects the source of high pressure gas to the valve means and to the gas supply pipe of the motor. A gas-bubbling-through-water type humidifier is incorporated in the system. The gas inlet of the humidifier tank is connected to the high pressure piping system upstream of its connection to the gas supply pipe of the motor, and the outlet pipe of the humidifier tank is connected to the high pressure piping downstream of its connection to the gas supply pipe of the motor. Thus ,the.humidifying system bypasses the motor. Further, a water supply is connected to the humidifying tank and the connections are so controlled by valves whereby the water in the tank may be replenished without shutting off the flow of the breathing mixture to the patient.

1 Claim, 2 Drawing [Figures DEFLATE VALVE 49 TO CATHETER IN l7 PATIENT 80 i l TO DRAIN S TAT MIENTEB 0H 2 3 I973 mm. mm Q i 23mm OP INVENTOR HARVEY B. JACOBS mom-40w wOmDOm 2O cbjw mv mm M ATTORNEY HIGH PRESSURERESUSCITATING AND VENTILATING-SYSTEM INCORPORATING HUMIDIFYING MEANS FOR THE-BREATHING MIXTURE While valves 22 and 23 are shown diagrammatically as two separate plug means,their passagesmay be incormeans in very lowpressure resuscitating or ventilating apparatus, no suitable humidifying means has been provided for effeciently and properly humidifying the breathing mixture in ventilating systems using high pressure. A,

An object of this invention is to provide humidifying means'suitable for incorporating in ahigh pressure resuscitating or ventilating apparatus, particularly the apparatus disclosed in my parent application, Ser. No. 59,206. v

A further objectis ,to provide a humidifierwhich will cooperatewith the :high pressure gas of the ventilating system to atomize and vaporize water 'to a desired degree and at a suitable rate, and thereby provide aproperly humidified breathing mixture in accordance with the particular requirements of the patient.

. Another object is to provide agas-bubbling-through water type humidifier means which is connected to the high pressure gas of the ventilating system and which is also connected to a suitable supply of water and provided with a valve system whereby the water in the humidifying tank maybe replenished without shutting off the flow of the breathing mixture to the patient and without removing the humidifying meansfromthe system.

Further objectsand advantages of this invention will be apparent from the following descriptions and accompanying drawings of which: I l I I HO. 1 is schematic view of the resuscitatingor ventilating apparatus disclosed in my co-pending application, Ser. No. 59,206, filed July 29, 1970 and incorporating breathing gas humidifying means and control valve means therefor; and,

FIG. 2 illustrates the alternate position of the cycle control valve means. 7

The resuscitating or ventilating system incorporating the humidifying means will be sufficiently described herebelow to fully disclose the functioning and control of the humidifying means and its cooperation with the 15. This source maybe compressed air, pure oxygen or air fortified with a higher percentage of oxygen than normal atmospheric air. The source is connected by conduit means 16 and 16. to a sputum trap 17. From sputum trap 17, a conduit means 18 extends to the catheter attached to the trachea of the patient.'

Conduit means 16-l6' has a series of three-way valves 21, 22'and 23 inserted therein. Valve 21 has a handle means 24 to move it to a selected position.

.porated in a single plug'valve'device a'taxially spaced planes. To illustrate theunitary operation of valves 22 and 23, a handle 25 is providedfor'each valve, the handle beingconnected for joint movementby a conne cting linkmeans 26. Valves 22 and 23 rotate inopposite directions. s

Suction or v acuumsource 27 has conduits 28'and 29 extending therefrom with conduit 29 connected to deflate valve means 30, and conduit 28 connected to valve 21. t s l I A two-way valve means 31 islocated'between conduits 16 and 16' and'functionsas an inflate valve. For

illustrative purposes, valves 30 and 31 are shown as separate valves; however,they work in unisonby connecting means 32 which connectsfthem to reduction gear drive 33.

It is preferable that the outletports 34a of the several passages 34 in valves 30 and 31 beof a tapered configu ration. Outlet portion 34a is elongated inthe direction of valve movement and may beof elliptical or diamond justable throttle valve'means-37 inserted in line 36, which valve isdiagrammatically illustrated as an adjus'table choke valve. I

A three-way valve 40 is connected by conduit 41 to valve 30 and by conduit 41' to valve-31. The function of valve 40 is to control the ratio of inflation pulses or phases to deflation phases during a revolution of valves 30-31. lt may be termed an inflation and delfation phase control valve. A conduit 42 connects valve 30 to conduit 16. A branch conduit 43connects conduit 42 to valve 40. A conduit 45 connects valves 22 and 23. To control the rate of flow of the oxygenated gasin accordance with the age and size of the patient, throttle or choke valve 47 isinserted in line 16 upstream of valve 31 and-a similar valve 47a is inserted in conduit 45. Valve 47 controls the rate of flow when the system operates automatically. Valve 47a: controls the rate of flow during. manual control of ventilatiomThe rate of flow of deflation gas from the'patient may be controlled byv throttle valve 48 inserted in suction line'29. The FIG. 1 illustrates the positions of the several valves in the system for automatic operation of the ventilating system. Air under suitable pressure flowsfrorn source 15 through conduits 16 and. 16' andthrough'the connecting passages in valves 21, 22, 31 and 23 to sputum cup and from there by conduit means 18 to the catheter. Thus, air with the proper selected percentage of oxygen flows tothe patient at a'rate controlled .by throttle valve 47. a A l At this phase of the cycle, valve: 30'e uts off the sell eral connecting conduits and valve 40 from suction conduit 29. q Y Valve means 31 and 30 areeontinuously rotated in the direction of the arrows 49 at the proper desired speed by air motor 35. Assuming the setting of the valves in FIG. 1 to be 0,at 90 ofrotation, valvel31 blocks flow from conduit 16 to conduit 16', and valve 30 connects suction source 27 and conduit 29 to conduit 41 and through valve 40 to conduits 43, 42 and 16. and thereby the catheter is connected to the suction source whereby deflation or exhalation of the patient is aided. At 180 of rotation, valve 31 still blocks air flow to 16', and valve 30 connects conduit 42 to conduit 29 and therethrough to suction source 27. At 270 of rotation, valve 31 still blocks flow to conduit 16 and valve 30 still connects conduit 42 to conduit 29. At 360 of rotation valves 30 and 31 again assume the positions of FIG. 1 and air is again delivered to the patient to aid in the inhalation phase of breathing.

Thus, a single cycle or rotation of valve 30 and 31 results in one inflation and three deflation phases. Under certain conditions, it may be desirable to have the same extent of inflation and deflation. Inflation and deflation phases control valve 40 is provided for such operation. If valve 40 is moved by its handle 50 to the position illustrated in FIG. 2, the following connections occur during a single cycle or rotation of valve means 30 and 31. At valve 31 connects conduits l6 and 16' and suction conduit 29 is cut off from all connection by valve 30. At 90 of rotation in the direction of arrows 49, valve 31 disconnects conduits 16 and 16 and connects conduits 16 and 41; and through the passages in valve 40 conduits 41, 43, 42 and 16' are interconnected, for a second inflation phase, while deflation (suction) is blocked. At 180 or rotation, conduit 16 is cut off from the other conduits by valve 31. Suction conduit 29 is connected by valve 30 to conduits 42, 16', and 18 to the catheter for the deflation phase. At 270 of rotation, valve 31 still cuts off flow from conduit 16 and valve 30 connects conduits 29, 42 and 16' for a second deflation phase. At 360 of rotation, the valves assume the positions illustrated in FIG. 2, that is, the 0 position, in which an inflation phase is initiated.

Thus, with valve 40 in the position of FIG. 2, there are two inflation and two deflation phases during a cycle or a revolution of the valve means 30 and 31.

Under certain conditions, the patient cannot be subject to the automatic inflation and deflation and the operator must manipulate the inflation and deflation phanal pressure. The tank has a high pressure gas input pipe 61 which is secured by a conventional, quick acting, detachable coupling means 62 to high pressure pipe 63. Pipe 63 is connected to pipe 16 upstream of throttle valve 47. A throttle valve 64 is inserted in pipe 63 for controlling the rate of flow of humidifying gas and also for shutting off the flow through the pipe. A pipe connected to a suitable water supply is joined to pipe 63 upstream of coupling means 62. A check valve 67 opening toward tank 60 is inserted in pipe 65. For controlling the temperature and the degree of vapor saturation of the humidified breathing mixture, an elecses in accordance with the abnormal conditions of the patient. Valves 22 and 23 are shifted by means of their handles from their positions of FIG. 1 to their opposite positions. Valve 30, 31 and 40 are by-passed, and at the same time flow to motor 35 is shut off by valve 22. Thus, valves 22 and 23 interconnect conduit '16 to 16' at sputum cup 17 by means of conduit which bypasses the valve means 30, 31 and 40, and their interconnected conduits.

Valve 21 is then manipulated by the operator from one position to another by handle 24. The position shown in solid lines is the inflate position wherein oxygenated pressure gas regulated by throttle valve 47a flows from source 15 to conduits 16, 45, 16, 18 to the catheter. When deflation is desired, valve 21 is moved anticlockwise 90 to the dotted line positions of handle 24. In this deflate position, suction source 27 is connected by the valve means to conduits 16, 45, 16','l8 and the catheter. The duration of the inflation and deflation phases will be regulated by the operator in accordance with the requirements of the patient which is under his visual observation.

The humidifying means comprises a tank 60, preferab ly made of stainless steel or other mateiral which may b'esubject to sterilization and can withstand high intertric heater means 68 is provided and is controlled by adjustable thermostat 69 whereby any desired temperature may be selected.

Tank 60 may be provided with a transparent sight tube 71 whereby the water level may be visually observed. A drainage valve 72 for emptying the tank whenever desired is inserted at the bottom of tank 60.

A tank outlet pipe 73 is secured to the top of tank 60. Pipe 73 may have a heat exchange means therein in the form of a heavy metal tube 74 to condense any excess water vapor which will drain back to the tank. Pipe 73 may have a finned portion in lieu of tube 74 to act as a heat exchanger to permit the outside air to cool and condense any excess water vapor generated in the tank.

Outlet pipe 73 is connected by a conventional quickly detachable coupling means 75 to pipe 77 connected to pipe 16 between throttle valve 47 and valve 31, preferably close to valve 31. A check valve 78 opening towards line 16 is inserted in pipe 77. Pipe 77 terminates in a shut-off valve 79 whereby pipe 77 may be closed to drain outlet 80 or be opened thereto. An

optional throttle valve 82 may be'inserted in pipe 77 to control the flow of humidified gas and may be used in conjunction with throttle valve 64in line 63.

A gas disperser 83 may be connected to the open end of'tube 61 whereby the gas is dispersed into'numerous paths to increase the bubbling effect. Disperser 83 may be in the form of a hollow cylindrical body having numerous parts in its cylindrical wall, or may assume any other well known structure for breaking up a flo'w of fluid into numerous paths, as for example, a porous body, perforations in the walls of inlet tube 61 or any other similar structure.

In order to insure that the bubbling gas picks up atomized or vaporized water particles, a baffl'e'means comprising spaced perforated plates 85 are placed above the water level. Unduely large droplets or particles of water would impact against the plates-and would not be carried along by the gas stream to outlet pipe 73.

The application of the humidifying system is initiated when application of the ventilating system is initiated, assuming throttle valve 64 is set to permit the desired flow of gas to tank 60, and the tank is partly filled with water, as illustrated in FIG. 1. Check valve 67 is closed under the pressure of the gas flowing in pipe 63. The gas flows through the open ends of inlet pipe 61 and through the gas dispersion unit 83 close to the bottom of tank 60 and bubbles through the properly heated water. The fine bubbling causes atomization and vaporization of the water, and the outgoing gas at outlet pipe 73 is saturated with water moisture. Massive bubbling and very large water particles are blocked and returned to the water by baffle means 83. Excess moisture is condensed by passing through cooling means 74. The humidified gas then passes through pipe 77 and joins the gas flowing the inflating valve 31.

The amount of moisture may be controlled by regulating the flow of gas in pipe 63 by throttle valve 64.

To replenish the water in tank 60, valve 64 is closed to stop the flow of gas in pipe 63 and valve 79 is actuated to connect pipe 77 to the drain 80. Shut off valve 86 in pipe 65 is opened and under such pressure conditions, water flows through pipe 65 and check valve 67 into pipes 63 and 61 and the tank 60. The water level may be observed through sight tube 71, and when it reaches the desired height valve 79 is turned to disconnect pipes 73 and 77 from the drain 80. This action stops the flow of water and valve 83 in pipe 65 is closed to secure this inflow. By opening and regulating valve 64 the flow through pipe 63 is again resumed and humidified gas flows to valve 31.

If sterilization of tank 60 is desired it may be quickly disconnected from pipes 63 and 77 by means of quick acting coupling means 62 and 75. Thermostat 69 may be detachably plugged into the heater means.

Check valves 67 may be eliminated and check valve 77 may be replaced by a normally shut off valve similar to valve 86. Thus in replenishing tank 60 valves 86 and 79 would be opened to permit water to flow into the tank and shut off valve replacing valve 77 would be closed.

While the invention has been described and illustrated in detail, it is to be clearly understood that this is intended by way of illustration and example only and is not to be taken by way of limitation.

I claim:

1. A ventilating apparatus comprising a source of high pressure breathing gas, inflating and deflating valve means, first pipe means connecting said source of breathing gas to said inflating valves means, output pipe means connected to said valve means for delivering breathable gas from the inflate valve means to the patient and for returning the exhalation from the patient to the deflate valve means, air motor means operatively connected to said inflate and deflate valve means to cyclically actuate the same, a pressure gas supply line connecting said first pipe means to said air motor, high pressure humidifying means between said breathing source and said inflating and deflating valve means comprising a tank having water therein, an inlet gas pipe fed with high pressure breathing gas opening below the water level to permit a heat exchanger, a condenser which removes liquid water from said highly humidified vapor in said outlet and thereby prevent flooding, a heater to maintain a high temperature in the liquid so as to assure a supply of highly humidified air at high pressure in the tank outlet pipe without trapped water therein, gas flowing through the inlet pipe to bubble through the water and thereby become highly humidified, a tank outlet pipe to permit the humidified gas to flow out of the tank, a second .pipe means connecting said inlet pipe to said first pipe means upstream of said pressure gas supply line, and a third pipe means connecting said tank outlet pipe to said first pipe means downstream of said pressure gas supply line, whereby the air motor is bypassed by the humidified air flow, which prevents the loss of water at the interior from the humidified gas going to the patient. 

1. A ventilating apparatus comprising a source of high pressure breathing gas, inflating and deflating valve means, first pipe means connecting said source of breathing gas to said inflating valves means, output pipe means connected to said valve means for delivering breathable gas from the inflate valve means to the patient and for returning the exhalation from the patient to the deflate valve means, air motor means operatively connected to said inflate and deflate valve means to cyclically actuate the same, a pressure gas supply line connecting said first pipe means to said air motor, high pressure humidifying means between said breathing source and said inflating and deflating valve means comprising a tank having water therein, an inlet gas pipe fed with high pressure breathing gas opening below the water level to permit a heat exchanger, a condenser which removes liquid water from said highly humidified vapor in said outlet and thereby prevent flooding, a heater to maintain a high temperature in the liquid so as to assure a supply of highly humidified air at high pressure in the tank outlet pipe without trapped water therein, gas flowing through the inlet pipe to bubble through the water and thereby become highly humidified, a tank outlet pipe to permit the humidified gas to flow out of the tank, a second pipe means connecting said inlet pipe to said first pipe means upstream of said pressure gas supply line, and a third pipe means connecting said tank outlet pipe to said first pipe means downstream of said pressure gas supply line, whereby the air motor is bypassed by the humidified air flow, which prevents the loss of water at the interior from the humidified gas going to the patient. 